Surgical reconstruction of the foramen tympanicum: What is known and how we do it

Pons, M.; Lutz, Jean-Christophe; Sigaux, N.; Tavernier, L; Graillon, N.; Louvrier, Aurélien

doi:10.1016/j.jormas.2020.04.005

Cited by 5 publications

(6 citation statements)

References 26 publications

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“…For patients with symptomatic persistent FH, management is generally surgical with a goal to reduce the herniation and close the dehiscence between the EAC and the herniated tissue. 6,11,12,[14][15][16][17] Decision-making regarding surgical approach considers both the size of the dehiscence as well as the status of the temporomandibular joint and capsule. A fistula that is ≥4-5 mm may require a combined approach, while a smaller fistula may allow for a less invasive transcanal approach.…”

Section: Resultsmentioning

confidence: 99%

“…For smaller defects, perichondrium may be sufficient for reconstruction; however, more robust grafting material, such as tragal cartilage, temporalis muscle, bone pâté, iliac bone crest, collagen mesh, polypropylene, or titanium mesh, may be beneficial in reconstructing larger defects. 6,12,14,16,17 It is the authors' practice to utilize perichondrium and/or tragal cartilage given its adaptability, availability, and limited associated morbidity contrasted with the potential risk of extrusion of non-native substances through thin canal skin. Grafts may be secured with fibrin glue or tacking sutures to minimize graft displacement with temporomandibular joint movement during the postoperative healing period.…”

Section: Resultsmentioning

confidence: 99%

“…Although incidental persistent FH is diagnosed in 11.5%-20% of individuals undergoing temporal bone imaging, few studies have described the clinical nature of this pathology. [2][3][4] Available literature reports on single cases [5][6][7][8][9][10][11][12][13][14] or small case series 15,16 that highlight the presentation and management variability associated with this pathology. Understanding of this pathology from the lone review examining temporomandibular joint herniation into the EAC is limited given the wide variance in literature and the presentation of all EAC fistula patients, including spontaneous and non-spontaneous fistulae, as a single group in this study; therefore, conclusions are restricted when looking specifically at persistent FH.…”

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confidence: 99%

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Persistent foramen of Huschke: Presentation, evaluation, and management

Macielak

Nassiri

Fillmore

et al. 2022

Laryngoscope Investig Oto

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Objective: Describe the presentation and management strategy for patients with symptomatic foramen of Huschke (FH).Patients: Adults with persistent FH confirmed on imaging.Interventions: Diagnosis and management of symptomatic persistent FH.Main outcome measure: Resolution of otologic symptoms.Results: A total of four patients with symptomatic, radiographically-confirmed persistent FH were included. The majority of patients endorsed otalgia (n = 4) and otorrhea (n = 3), and only one patient was noted to have a conductive hearing loss. All patients were noted to have dynamic movement of an external auditory canal mass with mandible manipulation on examination, and all patients had an identifiable fistula on imaging. Patients underwent surgical intervention, including both preauricular (n = 2) and transcanal (n = 2) approaches, and all endorsed symptomatic resolution after convalescence.Conclusions: Persistent FH remains an uncommon and potentially underrecognized cause of otologic symptoms. Diagnosis requires a high index of suspicion, and one must rely on both key examination findings and imaging to confirm this diagnosis. In appropriately selected patients, surgical intervention can provide durable symptomatic resolution.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Persistent foramen of Huschke: Presentation, evaluation, and management

Macielak

Nassiri

Fillmore

et al. 2022

Laryngoscope Investig Oto

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“…The foramen of Huschke is present in up to 20% of the population and can be identified in about 65% unilaterally and in 35% bilaterally [ 18 ]. The shape of the tympanic foramen is mostly oval [ 19 ]. The mean axial diameter is described as between 3.2 and 4.5 mm, and the sagittal diameter is between 2.4 and 3.6 mm [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…The symptoms of the tympanic foramen are nonspecific, and the most common include TMJ herniation to the external auditory canal during mastication, or otologic symptoms like otalgia, clicking tinnitus, aural fullness, or otorrhea, which could indicate an ear canal salivary fistula [ 17 – 19 ].…”

Section: Discussionmentioning

confidence: 99%

Malignant myoepithelioma of the external auditory canal — a rare case report with literature review and clinical importance of foramen of Huschke

Mateášiková,

Salzman,

Michálek

2024

World J Surg Onc

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Background A malignant myoepithelioma is a rare tumor, mostly arising from the salivary glands. Myoepitheliomas of the ear have rarely been reported. The manuscript reports myoepithelial carcinoma of the external auditory canal (EAC) spreading to the infratemporal fossa. A clinician must be aware of anatomical variation of the bony EAC wall, such as the foramen of Huschke. This rare defect may be a pathway for spreading pathologies between these two anatomical regions. Case report We present a case of osteoma-like stenosis of the EAC, which turned out to be an extremely rare malignant tumor. The preoperative MRI and PET/CT revealed that two parts of the tumor communicated through a defect in the antero-inferior portion of the bony ear canal. No distant metastases were detected. Subsequently, the tumor was resected from the ear canal and the infratemporal fossa en bloc. Perioperatively the defect in the EAC wall was suspected of the foramen of Huschke. After the surgery, the older scans of the patient from the past showed no presence of a congenital EAC wall defect. Therefore, the authors concluded that the tumor aggressively grew through the bone due to its biological nature. Conclusion Malignant myoepithelioma of the external auditory canal is an extremely rare condition and could be misdiagnosed as other benign lesions. In cases of suspicious lesions, it is advisable to do a probatory biopsy from the EAC. Surgery is the treatment of choice in malignant myoepitheliomas, and regular follow-ups are essential to monitor for recurrence or metastatic disease. Any mass located at the antero-inferior portion of the EAC wall warrants close evaluation due to its potential for expansion from the EAC.

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Prevalence of foramen Huschke: evaluation of the association between mastoid pneumatization volume and the existence of foramen Huschke using cone beam computed tomography

Koç

Kaya

2020

Eur Arch Otorhinolaryngol

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Surgical reconstruction of the foramen tympanicum: What is known and how we do it

Cited by 5 publications

References 26 publications

Persistent foramen of Huschke: Presentation, evaluation, and management

Persistent foramen of Huschke: Presentation, evaluation, and management

Malignant myoepithelioma of the external auditory canal — a rare case report with literature review and clinical importance of foramen of Huschke

Prevalence of foramen Huschke: evaluation of the association between mastoid pneumatization volume and the existence of foramen Huschke using cone beam computed tomography

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